<!DOCTYPE html>
<html>
<head>
<meta charset="UTF-8">
<link rel="stylesheet" type="text/css" media="screen" href="../../css/bootstrap.min.css">
</head>
<body>
<div class="col-xs-12 col-sm-12 col-md-12 col-lg-12">
	<form class="form-horizontal" onsubmit="return false" id="form">
		<fieldset>
			<div class='form-group'>
				<label class='col-md-2 control-label'>fids</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='fids' type='text' name='fids' id='fids' data-bv-notempty='true' data-bv-notempty-message='fids 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>fammembeid</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='fammembeid' type='text' name='fammembeid' id='fammembeid' data-bv-notempty='true' data-bv-notempty-message='fammembeid 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>openId</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='openId' type='text' name='openId' id='openId' data-bv-notempty='true' data-bv-notempty-message='openId 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>fno</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='fno' type='text' name='fno' id='fno' data-bv-notempty='true' data-bv-notempty-message='fno 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>realName</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='realName' type='text' name='realName' id='realName' data-bv-notempty='true' data-bv-notempty-message='realName 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>sex</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='sex' type='text' name='sex' id='sex' data-bv-notempty='true' data-bv-notempty-message='sex 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>phoneNo</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='phoneNo' type='text' name='phoneNo' id='phoneNo' data-bv-notempty='true' data-bv-notempty-message='phoneNo 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>status</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='status' type='text' name='status' id='status' data-bv-notempty='true' data-bv-notempty-message='status 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>patientNo</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='patientNo' type='text' name='patientNo' id='patientNo' data-bv-notempty='true' data-bv-notempty-message='patientNo 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>socialSecurityCard</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='socialSecurityCard' type='text' name='socialSecurityCard' id='socialSecurityCard' data-bv-notempty='true' data-bv-notempty-message='socialSecurityCard 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>medicareCard</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='medicareCard' type='text' name='medicareCard' id='medicareCard' data-bv-notempty='true' data-bv-notempty-message='medicareCard 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>medicalCard</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='medicalCard' type='text' name='medicalCard' id='medicalCard' data-bv-notempty='true' data-bv-notempty-message='medicalCard 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>idCard</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='idCard' type='text' name='idCard' id='idCard' data-bv-notempty='true' data-bv-notempty-message='idCard 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>militaryId</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='militaryId' type='text' name='militaryId' id='militaryId' data-bv-notempty='true' data-bv-notempty-message='militaryId 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>agreementId</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='agreementId' type='text' name='agreementId' id='agreementId' data-bv-notempty='true' data-bv-notempty-message='agreementId 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>patientid</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='patientid' type='text' name='patientid' id='patientid' data-bv-notempty='true' data-bv-notempty-message='patientid 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>times</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='times' type='text' name='times' id='times' data-bv-notempty='true' data-bv-notempty-message='times 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>userid</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='userid' type='text' name='userid' id='userid' data-bv-notempty='true' data-bv-notempty-message='userid 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>accountid</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='accountid' type='text' name='accountid' id='accountid' data-bv-notempty='true' data-bv-notempty-message='accountid 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>famtime</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='famtime' type='text' name='famtime' id='famtime' data-bv-notempty='true' data-bv-notempty-message='famtime 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>csrq</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='csrq' type='text' name='csrq' id='csrq' data-bv-notempty='true' data-bv-notempty-message='csrq 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>hostcode</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='hostcode' type='text' name='hostcode' id='hostcode' data-bv-notempty='true' data-bv-notempty-message='hostcode 不能为空'>
				</div>
			</div>
			<div class='form-group'>
				<label class='col-md-2 control-label'>responsetype</label>
				<div class='col-md-10'>
					<input class='form-control' placeholder='responsetype' type='text' name='responsetype' id='responsetype' data-bv-notempty='true' data-bv-notempty-message='responsetype 不能为空'>
				</div>
			</div>


			<div class="form-actions">
				<div class="row" align="center">
					<div class="col-md-12">
					    <button class="btn btn-primary" onclick="location.href='appFamMembeList.html'">返回</button>
						<button class="btn btn-primary" type="submit" onclick="add()">
							<i class="fa fa-save"></i> 保存
						</button>
					</div>
				</div>
			</div>

		</fieldset>
	</form>
</div>
	<script type="text/javascript" src="../../js/libs/jquery-2.1.1.min.js"></script>
	<script type="text/javascript" src="../../js/jq.js"></script>
	<script type="text/javascript" src="../../js/plugin/bootstrapvalidator/bootstrapValidator.min.js"></script>
	<script type="text/javascript" src="../../js/common.js"></script>
	<script type="text/javascript" src="../../layui/layui.js"></script>
	<script type="text/javascript">
		layui.use(['layer','laydate'], function(){
		    var layer = layui.layer;
		});
		
		function add() {
			$('#form').bootstrapValidator();
			var bootstrapValidator = $("#form").data('bootstrapValidator');
			bootstrapValidator.validate();
		    if(!bootstrapValidator.isValid()){
			   return;
		    }
		    
		    var formdata = $("#form").serializeObject();

			$.ajax({
				type : 'post',
				url : '/appFamMembes',
				contentType: "application/json; charset=utf-8",  
				data : JSON.stringify(formdata),
				success : function(data) {
					layer.msg("添加成功", {shift: -1, time: 1000}, function(){
                        location.href = "appFamMembeList.html";
                    });
				}
			});
		}
		
	</script>
</body>
</html>
